Many of you have heard of, or maybe even know someone who has been diagnosed with Bipolar Disorder (also known as Manic Depressive Disorder).Because there is so much confusion about what this disorder is, how it affects people, and how it is treated, in this article I will attempt to clarify some of these issues.
Bipolar disorder is a biological condition in which people experience extreme changes in mood that are unrelated, and/or out of proportion to, events in their lives. The mood changes dramatically alter their thoughts, feelings, physical health, behavior, and ability to attend to daily life. These mood changes are not a choice, not a weakness, and not the person's fault; instead, they are the manifestation of a complicated neurotransmitter imbalance that usually requires medical intervention to manage.
There are four main mood changes that occur for people with bipolar disorder. These include mania, hypomania, depression, and mixed episodes. Mania can start out feeling good to people; they likely notice increased energy, creativity, and sociability. This can quickly escalate however, into a full-blown manic episode in which the person begins to feel either euphoric or irritable, needs very little sleep (and still has high energy), talks so fast that others have trouble following them, has racing thoughts, has a seriously diminished attention span, has an inflated sense of power or importance, and does reckless things without concern about the consequences (this might include spending large amounts of money, engaging in promiscious behavior, driving too fast, etc. ).Sometimes people experiencing mania can even develop hallucinations (seeing or hearing things that aren't there) or delusions (firmly believing things that aren't true). During a manic episode people usually deny that anything is wrong and get very angry with anyone who expresses concern or suggests there might be a problem. This denial and lack of insight into the situation can be very upsetting to family or friends who are worried and want to help.
Hypomania is a milder form of mania.People who are hypomanic show similar symptoms to people who are manic, but these symptoms are less severe and impair their functioning less dramatically. For example, hypomanic people might report an elevated mood, increased productivity, and increased sociability but no racing thoughts or inflated sense of importance.Hypomania usually feels very good to people but is a dangerous state in that it generally very quickly leads to either full-blown mania or a major depression.
When people experience a major depressive episode, they feel at least some of the following symptoms, that interfere with their functioning, for at least 2 weeks: feeling sad and/or losing interest in things they normally enjoy, changes in sleep patterns, changes in appetite, problems concentrating and/or difficulty making decisions, motor disturbances (feeling as though they've been slowed down, or agitated with trouble sitting still), feelings of worthlessness, guilt, and/or low self-esteem, loss of energy, feeling tired all the time, and/or thoughts of suicide. As you can imagine, this mood state is incredibly distressing to people and represents a marked change from mania and hypomania. It can also be very upsetting to one's family and friends who may want desperately to be able to say or do something to help bring their loved one out of the depths of such a depression.
Finally, people with bipolar disorder sometimes experience what's called mixed episodes. These are mood states that involve symptoms of both mania and depression, that occur either simultaneously or in frequent alternation throughout the course of a day. Mixed episodes can be extremely difficult to understand and manage and can cause significant impairment in day to day functioning. For example, the person may feel agitated or excitable but also irritable and depressed. It is easy to imagine how difficult it would be to experience this cluster of emotions simultaneously and still attend to day to day responsibilities.
Due to the severity of impairment and distress that can come from experiencing these mood changes, it is extremely important to diagnose and treat bipolar disorder as early as possible. There is also emerging research that suggests that untreated bipolar disorder gets worse with time and age, and can even permanently alter brain size and chemistry.
Treatments for bipolar disorder almost always include the use of pharmacological interventions. Usually the medications that are prescribed include a mood stabilizer (like Lithium, Depakote, or Tegretol) and an antidepressant (such as Wellbutrin, Prozac, Paxil, Zoloft, etc. ). This combination of medications tends to help stabilize people's moods significantly and to improve their ability to attend to daily relationships and responsibilities. In addition to pharmacological treatment, it is frequently a good idea for someone with bipolar disorder to have psychotherapy treatment as well. A therapist can help the person learn to recognize early warning signs of mood instability so that, in case they occur again, intervention and treatment can begin early. Therapy can also help people with bipolar disorder cope with any disruptions in work, school, or relationships that have occurred due to their mood changes. Developing coping skills and sticking to medication treatment (even when feeling better) are other things that might be discussed in therapy. Additional help might be found at support groups for people with bipolar disorder, in which people with the diagnosis come together to talk about their experiences and how they manage their illness.
If the early warning signs of bipolar disorder are not recognized and treated with medication or therapeutic interventions, people can often end up with impairment severe enough that they need to be hospitalized for a period of time until their moods can be stabilized. Once they are released from the hospital, it is very important to maintain whatever medication regimen has been started, and to seek follow-up help from an outpatient therapist.
While there is no one identified cause of bipolar disorder, it tends to run in families. This can be helpful to know in that, if you know that someone in your family has bipolar disorder, you can be very alert to potential signs of it in yourself, thereby catching and treating it early. Most of the time (although not always), symptoms of bipolar disorder emerge in late adolescence or early adulthood.Given this, it is particularly important that college students be aware of the signs of bipolar disorder as it is likely that someone in your classes or dorms will be diagnosed during your time in school here.
If you have been diagnosed with bipolar disorder, you probably already know a lot of this information. For those of you with a loved one who has been diagnosed with bipolar disorder, you may need some help in understanding the illness and learning how to cope with your friend/family member's mood changes without taking them personally. There may be specific strategies you can learn to help you minimize the impact of the disorder on your life and relationship.